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Medicine Year 4 > ENT > Flashcards

ENT Flashcards

1
Q

What might uvula deviation indicate in tonsillitis?

A

Peritonsillar abscess (quinsy)

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2
Q

First and second line treatment for otitis externa

A

First: Topical aceitic acid spray
Second: Topical combination steroid and antibiotic drops (if hearing loss)

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3
Q

What does bilateral purple swelling of the nasal septum indicate and how is it managed?

A

Septal haematoma

Urgent ENT review

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4
Q

Sudden onset vertigo, hearing loss and tinnitus after a viral infection with horizontal nystagmus and nausea/vomiting

A

Labyrinthitis

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5
Q

Unilateral tonsillar swelling and fever

A

Quinsy

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6
Q

Pharyngitis and Tonsillitis with splenomegaly

A

Infectious mononucleosis

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7
Q

Which antibiotics are avoided in EBV

A

penicillin

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8
Q

Tonsils which meet in the middle and are covered by a white film that bleeds when you attempt to remove it

A

Acute bacterial tonsillitis

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9
Q

Episodes lasting 20min of unilateral tinnitus, sensioneural hearing loss and vertigo with a ‘full’ sensation

A

Meniere’s disease

Acoustic neuroma is similar but more progressive

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10
Q

Bilateral conductive hearing loss and tinnitus with a FHx

A

Otosclerosis

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11
Q

2 year old with frequent otitis media and delayed speech

A

Glue ear (otitis media with effusion)

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12
Q

Management of a simple perforated eardrum

A

Reassure and follow up in 6 weeks

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13
Q

Define otalgia

A

Ear pain

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14
Q

ABx of choice for otitis media

A

Amoxicillin

clarithroymycin/erythromycin if allergic

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15
Q

Sudden onset vertigo WITHOUT hearing loss after a viral illness

A

Vestibular neuronitis

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16
Q

Management of an auricular haematoma

A

Same day ENT assessment

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17
Q

5 causes of drug ototoxicity

A

Aminoglycosides, furosemide, aspirin, cytotoxic drugs, NSAIDs

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18
Q

80 year old with sensioneural hearing loss at high frequencies

A

Presbycusis

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19
Q

Hx of unilateral vertigo and hearing loss with an absent corneal reflex

A

Acoustic neuroma

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20
Q

What condition is associated with bilateral acoustic neuroma

A

Neurofibromatosis type 2

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21
Q

Define exostosis

A

Benign bony growth (conductive hearing loss)

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22
Q

Management of unilateral polyp

A

Red flag for nasopharyngeal cancer - urgent referral to ENT

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23
Q

First line management of bilateral polyp

A

Topical corticosteroid therapy

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24
Q

Treatment of Ramsay Hunt Syndrome

A

Oral aciclovir and corticosteroids

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25
Q

What is Ramsay Hunt Syndrome?

A

Herpes zoster oticus
Auricular pain progressing to a vesicular rash around the ear, tinnitus and vertigo.
?Facial nerve palsy

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26
Q

4 features of mastoiditis

A

Persistent earache, conduction deafness, profuse discharge and posterior auricular tenderness

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27
Q

Management of mastoiditis

A

Refer urgently for IV ABx

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28
Q

Cause of the majority of sudden onset sensioneural hearing loss

A

Idiopathic

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29
Q

Risk factor for otosclerosis

A

Pregnancy

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30
Q

Management of vestibular neuronitis

A

Prochlorperazine in the ACUTE phase (only for a few days)

Then vestibular rehabilitation

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31
Q

Following referral to ENT, how are patients with sudden onset sensorineural deafness treated?

A

high-dose oral corticosteroids

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32
Q

Interpretation of Rinne and Weber

A

Rinne result: Air conduction > bone conduction bilaterally

Weber result: Lateralises to unaffected ear

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33
Q

Which nerve palsy is associated with sarcoidosis?

A

Sarcoidosis

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34
Q

6 associations with nasal polyps

A 
asthma (particularly late-onset asthma)
aspirin sensitivity
infective sinusitis
cystic fibrosis
Kartagener's syndrome
Churg-Strauss syndrome
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35
Q

Does MND and MS cause vertigo?

A

MND: No
MS: yes

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36
Q

Management of a mouth ulcer for greater than 3 weeks

A

2 ww to oral surgery

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37
Q

Biggest risk factor for malignant otitis externa

A

Diabetes

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38
Q

Management of unilateral middle ear effusion in an adult

A

2ww to ENT

Nasopharyngeal cancer

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39
Q

What is Ludwigs angina?

A

Cellulitis at the floor of the mouth

Risk in immunocompromised patients with poor dentition

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40
Q

Treatment of otitis externa in diabetics

A

Ciprofloxacin to cover pseudomonas

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41
Q

Where is little’s area

A

Anterior nasal septum

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42
Q

When do you treat sinusitis and what do you treat it with?

A

After 10 days: phenoxymethylpenicillin and intranasal steroids/decongestant

43
Q

What is the most important part of the tympanic membrane to visualise in a patient with purulent ear discahrge

A

Attic

Cholesteatoma

44
Q

Treatment for a perforated eardrum that does not resolve spontaneously

A

Muringoplasty

45
Q

Bilateral high-frequency hearing loss

A

Presbycusis

46
Q

Globus (feeling of a lump in the throat), hoarseness and no red flags

A

Laryngopharyngeal reflux

47
Q

dysphagia, halitosis and regurgitation of undigested food with a mass below the sternocleidomastoid

A

Pharyngeal pouch

48
Q

sensation of a lump being stuck in the throat, with no physical findings present

A

Globus hystericus

49
Q

When would you treat otitis media with supportive care verus antibiotics

A

ABx if ear pain and bilateral sx in a child under 2

Systemically unwell child needs ABX

50
Q

Room spinning for 10 seconds when moving the head

Some nausea, no vomiting, hearing loss or tinnitus

A

Benign paroxysmal positional vertigo

51
Q

Diagnosis and treatment of BPPV

A

Diagnosis: Dix-Hallpike manoeuvre (rotatory nystagmus)
Treatment: Epley manoeuvre

52
Q

Management of worsening stridor in post-op neck surgery

A

Urgent removal of sutures and call for senior help

53
Q

smooth, fluctuant, non-tender unilateral mass that does not transilluminate located anterior to the sternocleidomastoid muscle

A

Branchial cyst

54
Q

Red flag nosebleeds

A

Recurrent and unilateral

55
Q

Is coughing a red flag for nosebleeds

56
Q

ABx for tonsillitis

A

Phenoxymethylpenicillin for 10 days

57
Q

What is sialadenitis

A

Inflammation of the salivary gland

58
Q

Where are the 3 salivary glands found?

A

the parotid glands are anterior and inferior to each ear
the submandibular glands lies below the angle of the jaw
the sublingual glands lie beneath the tongue

59
Q

Chronic cough and peristent headache

60
Q

Pain above and lateral to the eye

A

Temporal arteritis

61
Q

Shooting pain across the face worse when you touch it

A

Trigeminal neuralgia

62
Q

Age of onset of otosclerosis

63
Q

Ear pain, epitaxis and cervical lymphadenopathy

A

Nasopharyngeal carcinoma

64
Q

What is rhinitis medicamentosa and how is it treated?

A

Rebound nasal congestion brought on by extended use of topical decongestants
Treated by stopping the decongestant

65
Q

swelling in the subcutaneous tissue of the posterior triangle which transilluminates

A

Cystic hygroma

66
Q

midline cyst which moves up on tongue protrusion and does NOT transilluminate

A

Thyroglossal cyst

67
Q

Most common bacterial cause of otitis media

A

Haemophilus influenzae

68
Q

Management of all post-tonsillectomy haemorrhages

A

Refer immediately to ENT
If within hours then arrange immediate return to theatre
If a few days later then commonly associated with wound infection (IV ABX)

69
Q

Failure of all emergency management for epistaxis

A

Ligation of the sphenopalatine artery in theatre

70
Q

Management of acute sensorineural hearing loss

A

Urgent ENT assessment for audiology and brain MRI

71
Q

What is tachyphylaxis

A

progressive decrease in response to a given dose

72
Q

Treatment of epistaxis from an anterior bleeding source that is visualized

A

Silver nitrate cautery

73
Q

Remember that a goitre is a thing for neck lumps that move on swallowing

74
Q

Common tumour of the parotid gland

A

Pleomorphic adenoma

75
Q

Examination of menieres

A

Nystagmus and positive rombergs test

76
Q

Unilateral symptoms in chronic rhinosinusitis

A

Referral to ENT

77
Q

Recurrent ear discharge

A

Cholesteatoma

78
Q

Treatment for chronic sinusitis

A

Nasal irrigation with saline solution

79
Q

Sudden onset dizziness with headache and difficulty walking

A

Cerebellar stroke

80
Q

What infection is tonsillar SCC associated with

A

HPV infection

81
Q

pain on palpation of the tragus, itching, discharge and hearing loss

A

Otitis externa

82
Q

Age of presentation of cholesteatoma

A

10-20 years

83
Q

What increases the risk of cholesteatoma

A

Cleft palate

84
Q

Naseptin (chlorhexidine/neomycin) cream contains peanut oil

85
Q

Complication of thyroid surgery

A

Damage to parathyroid glands can result in hypocalcaemia causing QT elongation

86
Q

Elderly patient dizzy on extending neck

A

Vertebrobasilar ischaemia

87
Q

Menieres prevention and treatment

A

Prevention: betahistine
Treatment: prochlorperazine

88
Q

Treatment of quinsy

A

IV ABx and surgical drainage

89
Q

What type of hearing loss is noise related hearing loss

A

Sensorineural

90
Q

5 causes of gingival hyperplasia

A

phenytoin, ciclosporin, calcium channel blockers and AML

91
Q

management of acute necrotizing ulcerative gingivitis (halitosis, mouth pain and ulceration) with fever

A

Paracetamol + Oral metronidazole + Chlorhexidine mouthwash

92
Q

Samter’s triad

A

asthma + aspirin sensitivity + nasal polyposis

93
Q

Medication to avoid in asthma

A

Beta blockers
Aspirin
NSAIDs

94
Q

Slow growing, painless, mobile lump in the parotid gland of older female

A

Pleomorphic adenoma

95
Q

first-line treatment for impacted ear wax

A

olive oil drops

96
Q

Management of spreading erythema after otitis externa

A

Oral flucloxacillin

97
Q

Management of Ludwigs Angina

A

999 immediate transfer to hospital

98
Q

Persistent unexplained hoarseness in a patient aged >45 years old

A

Urgent referral to ENT and CXR

99
Q

Adults are generally required to have had a failed trial of hearing aids before having a cochlear implant

100
Q

Management of children presenting with glue ear with a background of Down’s syndrome or cleft palate

A

ENT referral

101
Q

Child under 2 with otitis media

A

Prescribe abx if bilateral

102
Q

otitis media with perforation

103
Q

Management of pleomorphic adenoma

A

Routine surgical removal due to risk of malignant transformation

104
Q

Metastatic SCC in cervical lymph node

Most likely primary site

A

Nasopharynx

Medicine Year 4 (13 decks)

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